CHANGES to how care at home is provided to around 600 residents living in Monmouthshire, which has Wales’ fastest growing older population, have been agreed by the county council. 

Monmouthshire has an ageing population, with more than a quarter of residents aged 65 or over and at the moment a mixture of council staff and independent care providers support people living independently at home by helping them wash, dress and prepare meals but commissioned domiciliary care is costing Monmouthshire County Council around £6 million a year. 

Since 2011 the council has used a range of independent providers on its framework who it has agreed payment rates with but increasing demand has seen the council having to mostly rely on “spot purchasing” with approved providers at generally higher rates. 

Figures show the framework now accounts for just 19 per cent of the care provided with more expensive approved providers meeting 57 per cent of care hours and the council’s own staff, who are meant to focus on more short-term rehabilitation care, providing 24 per cent. 

Councillor Ian Chandler, who has responsibility for social care, said the council provides around 8,000 hours of care a week and has reduced the hours of unmet need to around 306 a week, from a high of 1,262 in October 2022. 

Increased demand since the Covid pandemic and the county’s aging population is placing a greater strain on the service which the council had already been trying to reform. 

It had trialed a model in Usk, where for the first time, it offered providers a guaranteed number of hours which it said has helped in planning and recruitment of staff. 

The council’s Labour-led cabinet has now agreed to adopt block contracts as its main way of delivering care. 

Green Party cabinet member Cllr Ian Chandler said the new contracts would build on the pilot in Usk and said: “We’ll deliver domiciliary care through a number of block contracts but we will still need to spot purchase for more complex cases and fill any gaps.” 

The council’s own in house staff will then be able to focus on reablement. 

Labour councillor Catrin Maby asked how changes will impact those receiving care and Cllr Chandler acknowledged there could be some disruption as care companies, and carers, change but said over the longer term there should be improved continuity of carers. 

Staff will also be able to transfer to new employers under TUPE arrangements which protect employment rights. 

The block contract terms and conditions will include a “fair and reasonable hourly rate” which will be a flat rate with no premiums for part hours while the block and spot purchasing contract terms and conditions for staff will include payment of the real living wage, a mileage rate, payment for travel time, holidays, and contract terms and the council will ensure these are adhered to. 

It is intended to introduce the new contracts, first in the south of the county where reliance on spot purchasing is at its highest, from November this year and the council will also prepare to implement new contracts across the rest of the county from February 2025 through to February 2026.